The policy‐practice nexus of electronic health records adoption in the UK NHS (original) (raw)

2011, Journal of Enterprise Information Management

PurposeThis paper seeks to report the findings from a seven‐year study on the UK National Health Service on the introduction of an electronic health record for 50 million citizens. It explores the relationship between policy and practice in the introduction of a large‐scale national ICT programme at an estimated value of £12.4bn.Design/methodology/approachUsing a longitudinal research method, data are collected on the policy‐practice nexus. The paper applies institutional theory using a conceptual model by Tolbert and Zucker on the component processes of institutionalisation.FindingsThe findings suggest that institutional forces act as a driver and an inhibitor to introducing enabling technologies in the health‐care environment. A process analysis shows that, as electronic health records force disruptive change on clinicians, healthcare managers and patients, culturally embedded norms, values and behavioural patterns serve to impede the implementation process.Research limitations/im...

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